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2012-12-06

Make database research part of your chairside protocol

The next generation of dentistry, beginning with the graduating class of 2013, will smartly reap data from a vast digital ecosystem. Their predecessors didn’t search with the right key words, and didn’t find what they were seeking. Today’s pervasive data hunger — paired with the need for speed on a variety of devices — has web developers and content experts on overdrive disseminating searchable news fast.

According to Monique Levy, vice president of Research, Manhattan Research, Manhattan, NY, “At least 82 percent of doctors access data at their fingertips via smartphones each morning. And we are moving quickly to the more intelligent, sophisticated, proficient systems to access up-to-date information.” All this points to just how critical the transformation toward databases has become for ensuring best healthcare practices with patients.

To avoid feeling as lost as a caveman with a USB cord, consider how far we’ve come.

Historical digital evolution in 30 seconds

Boxy desktop computers revolutionized digitized publishing in the 1908s, and many people tried something magical called email by 1990. Within a few years dental offices were adding digital recordkeeping to paper charts.1,2 And by 2000, a few dental offices claimed nearly complete conversion to paperless practices.

The digital movement just keeps cracking the ice of tradition. In the 2010s, grants from NIH’s National Institute of Dental and Craniofacial Research have been awarded to “dental-practice based research networks” — dentists in their offices who each and every day use materials and report what works.3,4 Dental insurers are partners in funding these networks because they, too, now employ investigators who do studies to learn the evidence of effective, efficient care. Yesterday, practitioners continued to do what they learned in dental school until their study club or a seminar taught them the latest; it could take a decade for research to migrate into practice. Today, digitally published information supplements print in organized dentistry, offering more rapid reporting of news and systematic reviews conforming to standardized protocol known as evidence-based dentistry.

Today’s dental students — who will be practicing in just a few months — will rapidly access data, and likely even get the latest research one-paragraph summary pushed by text, to eliminate the step of actively looking for news.5 In a world where cardiologists admit to using their cell phones during the least critical moments of bypass surgery,6 the doctor drives information usage protocol.

How dentists research patient questions

Dentist John Flucke is in a Kansas City general practice partnership. Dr. Flucke is also a technology buff. Ironically, he and I discussed how dental practice has been changing via a telephone (with a cord). He says hardly a week goes by when he doesn’t have a patient in his chair who seems to have more knowledge on a topic than some dentists do. Inevitably, this type of patient asks a tough question requiring a definitive response. For example, one recent patient if her new prescription of a higher dose blood pressure medication was making her drowsy. Explained Dr. Flucke: “Like most dentists, I have a working knowledge from my two semesters of pharmacology and can’t memorize everything, so I was not afraid to admit: ‘I don’t have the answer to that. I’ll find out and get back to you.’”

To look up articles on pharmacology, for example, databases and studies published in journals are available today from a range of sources: general googling; The Journal of the American Dental Association; the free government resource, Medline; FDA data via PDR; and a host of scholarly sites such as Epocrates, Up to Date, and Medscape. Depending on specialty or profession, additional resources are available.

Dr. Flucke learned from his preferred healthcare databases that his patient’s concern might be a real health issue. He called his patient back the next day and suggested she contact her prescribing physician about her drowsiness with the dosage change.

With another patient who balances several medical conditions, Dr. Flucke used the database of drug interactions before prescribing pain medication and an antibiotic. “My database said: ‘WARNING: NOT RECOMMENDED!’ I entered a different type of pain medication, and it was fine.”

Dr. Flucke said database research is chairside protocol of every practicing dentist: “The average person is 70 and is taking a range of medicines. When that patient comes into your office with a grocery list of medications and you need to prescribe an additional drug, you can’t use a book to check if it’s safe anymore. The updated drug interactions are critical so check for them digitally.”

A tradition of working for the dental profession. The Chicago Dental Society was organized in 1864 and incorporated in 1878. The objective of the Chicago Dental Society is to encourage the improvement of the health of the public, to promote the art and science of dentistry and to represent the intrest of the members of the profession and the public that it serves.